What Is a Stroke? Essential Information and Prevention Strategies
physical-health
A stroke is a medical emergency that can strike without warning with devastating effects. Stroke can affect anyone — children, young adults, and older adults. In the United States (US), someone has a stroke every 40 seconds.
This article will help increase your stroke awareness so you can recognize the signs and symptoms of stroke and learn what to do in an emergency situation. Additionally, you’ll learn steps you can take now to help prevent future strokes.
What Is a Stroke?
A stroke happens when a part of your brain isn’t getting enough blood flow. This may happen as a result of a blood clot or bleeding in your brain. If your brain cells don’t get enough blood flow, they also aren’t getting enough oxygen. Without oxygen, your brain cells will stop working and begin to die.
If enough brain cells die, it can cause permanent damage that impacts the abilities that area of the brain controls.
What Are the Types of Stroke?
The type of stroke is based on the cause. Ischemic stroke and hemorrhagic stroke are the two main types of stroke. Additional types of stroke include transient ischemic attack (TIA) and cryptogenic stroke.
Ischemic Stroke
An ischemic stroke is the most common type of stroke, causing about 80% of all strokes. Ischemic strokes happen when blood flow to your brain is blocked. Potential causes of blocked blood flow to the brain include:
- Thrombosis — when a blood clot forms in your brain
- Embolism — when a piece of a blood clot from another part of your body breaks off and travels to your brain
Some health conditions increase the risk of an ischemic stroke, including:
- Clotting disorders
- Atrial fibrillation
- Heart defects
- Microvascular ischemic disease
Hemorrhagic Stroke
A hemorrhagic stroke happens when you have bleeding in or around your brain that puts more pressure on the surrounding brain tissue.
There are two main categories of hemorrhagic stroke — intracerebral hemorrhage and subarachnoid hemorrhage.
An intracerebral hemorrhage happens when bleeding comes from blood vessels within the brain. High blood pressure is the most common cause of this type of stroke.
A subarachnoid hemorrhage happens when bleeding comes from the subarachnoid space — the space between your brain and the membrane that covers it. This type of stroke can be caused by:
- Aneurysm — weakened artery wall, which can be caused by high blood pressure or a birth defect
- Arteriovenous malformation (AVM) — a birth defect that causes a tangle of blood vessels
- Trauma
Transient Ischemic Attack
A TIA is a warning stroke caused by a temporary blood flow blockage in the brain. TIAs are temporary and typically don’t cause permanent damage. Symptoms from a TIA usually last only about five minutes or less. A TIA may indicate that a full stroke is more likely in the future.
Cryptogenic Stroke
A cryptogenic stroke is a stroke where the cause is unknown. This type of stroke may be more likely in African Americans and Hispanics.
Although the cause of cryptogenic stroke isn’t initially known, a team of physicians will work to make a diagnosis. Possible causes of cryptogenic stroke include:
- Atrial fibrillation (an irregular heartbeat)
- Heart structure problems
- Atherosclerosis (hardening of the arteries)
- Thrombophilia (a blood clotting disorder)
How Common Is a Stroke?
Strokes are very common. Stroke is the fifth leading cause of death in the US, where about 800,000 people have a stroke each year.
Who Do Strokes Affect?
You can have a stroke at any age. Several factors can increase your risk of having a stroke (called risk factors). Some risk factors you can’t control, while other risk factors are related to your lifestyle choices and may be improved or treated.
Stroke risk factors that you can’t control include:
- Older age
- Family history of stroke
- Black Americans
- Female sex
- History of stroke or heart attack
Stroke risk factors you can control or treat include:
- High blood pressure
- Smoking
- Diabetes
- Unhealthy diet
- Physical inactivity
- Alcohol use disorder
- Obesity
- High cholesterol
- Atrial fibrillation
- Sleep apnea
- Sickle cell disease
- Migraine headaches
- Carotid artery disease
- Peripheral artery disease
- Heart disease
What Are the Symptoms of Stroke?
Early recognition of stroke symptoms is important to ensure quick medical care. The faster a stroke is recognized and treated, the less chance there is for long-term disability.
The American Stroke Association has come up with an acronym to help you recognize the symptoms and warning signs of a stroke and act F.A.S.T.:
- F — face drooping
- A — arm weakness
- S — speech difficulty
- T — time to call 911
Other stroke symptoms include:
- Numbness
- Weakness
- Confusion
- Vision problems
- Difficulty walking
- Severe headache
Let’s discuss the F.A.S.T. symptoms in more detail.
Face Drooping
Face drooping caused by a stroke usually appears suddenly and may be accompanied by facial numbness. To tell if someone has facial drooping, you can ask them to smile and watch to see if their smile is uneven.
Arm Weakness
Muscle weakness is a possible stroke symptom. If you suspect someone is having a stroke, ask them to raise both arms. Watch for one arm drifting down.
Speech Difficulty
Slurred speech and difficulty choosing words are common stroke symptoms. You can ask a person you suspect is having a stroke to speak to see if they have any difficulty.
Time to Call 911
Every minute counts during a stroke. Don’t hesitate to call 911 (or your local emergency number) if you suspect someone is having a stroke. It’s also important to write down what time stroke symptoms started and give this information to the emergency team at the hospital.
How Is Stroke Diagnosed?
A stroke is a medical emergency, so things will move quickly at the hospital. In the hospital, an emergency team of physicians and nurses will order several different tests to rule out other medical conditions that may be causing your symptoms and learn what type of stroke you're having. Tests to diagnose a stroke may include a physical exam, blood tests, and imaging tests.
Physical Exam
During a physical exam, a physician will conduct several tests to evaluate your health, including your blood pressure, heart rate, respiratory (breathing) rate, and body temperature.
Additionally, you will undergo a neurological exam to see how the stroke is affecting your brain and nervous system.
Blood Tests
Blood tests to help diagnose stroke may include tests to check the following:
- Blood sugar levels
- Signs of heart damage
- Signs of infection
- Blood clotting ability
- Kidney function
- Liver function
Electrocardiogram
An electrocardiogram (ECG or EKG) is a test to diagnose heart problems. This test uses electrodes on your body to monitor the electrical activity of your heart. A computer translates your heart's electrical activity into a wave pattern.
An ECG can be used to diagnose heart problems that may be related to stroke, such as arrhythmia.
Imaging Tests
Imaging tests help physicians get an image of the inside of your body. Examples of imaging tests you may undergo to diagnose stroke include:
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Ultrasound
How Is Stroke Treated?
Stroke treatment depends on the type of stroke you’re having and how soon you can receive treatment once your symptoms begin.
Ischemic Stroke Treatment
The goal of ischemic stroke treatment is to remove the clot causing the stroke and restore blood flow to your brain. Physicians can do this with medications or medical procedures.
Medication for Ischemic Stroke
Medications called thrombolytics can help break up the blood clot in your brain. In general, the sooner you receive thrombolytics, the better. You can receive a thrombolytic medication up to 4.5 hours after stroke symptoms began. This is why it’s so important to note the time that symptoms started (the T. in F.A.S.T.).
Medical Procedures for Ischemic Stroke
Endovascular procedures are medical treatments that occur inside the blocked vessel. Your physician may use a thin, flexible tube (catheter) to deliver thrombolytic medications directly to the blood clot in your brain. If the clot is too large for thrombolytic medicine to break down, your physician may use a device attached to the catheter to remove the clot.
Hemorrhagic Stroke Treatment
The goal of hemorrhagic stroke treatment is to control bleeding and relieve the pressure on the brain. Lowering high blood pressure is often the first priority if you have a hemorrhagic stroke. This is usually accomplished with blood pressure medications.
If you’re currently taking blood thinning medications, you may also receive medication or blood products to counteract the effect and reduce bleeding.
If the pressure on your brain is too high, you may need surgery to remove the blood and relieve the pressure. Surgery may also be necessary to repair damaged blood vessels.
Stroke Recovery and Rehabilitation
After you receive emergency stroke treatment, recovery and rehabilitation can begin. Your rehabilitation plan will be personalized based on your age, your overall health, and which abilities you need to regain. Rehabilitation may include the following therapies:
- Speech therapy — therapy to help you improve your ability to control the muscles that help you talk, eat, drink, and breathe
- Physical therapy — therapy to help you regain your ability to move your body
- Occupational therapy — therapy to help you regain your ability to complete daily activities
- Cognitive therapy — therapy to improve your memory and concentration
You will work with your healthcare team to figure out the best rehabilitation plan for you based on your degree of disability from the stroke, your lifestyle, and your priorities.
Can You Prevent Stroke?
Up to 80% of strokes are preventable. As discussed above, some stroke risk factors can’t be changed, such as your age, sex, and family history. However, making healthy lifestyle choices and controlling your medical conditions can help reduce your risk of stroke.
Making Healthy Lifestyle Choices
Healthy lifestyle choices can help you stay healthy and prevent stroke. Choosing healthy foods and drinks is one of the most important lifestyle choices that can affect your risk of stroke. A healthy diet should include plenty of fruits and vegetables. Limiting foods high in saturated and trans fats and sodium can help prevent medical conditions that increase your stroke risk, such as high cholesterol and high blood pressure.
It’s also important to stay active with regular physical activity to help you lower your blood pressure and cholesterol levels. Most adults should get about 150 minutes of moderate-intensity exercise each week. That’s about 30 minutes most days.
A healthy diet and regular physical activity can also help you maintain a healthy weight. Overweight and obesity are risk factors for stroke.
Other lifestyle habits that can reduce your stroke risk include:
- Limit or avoid alcohol
- Avoid smoking or other tobacco use
- Manage stress levels
Talk to your physician for recommendations on the best diet and exercise plan for you based on your abilities and needs.
Controlling Medical Conditions
Several medical conditions can increase your risk of stroke, including:
- Diabetes
- High blood pressure
- High cholesterol
- Heart disease
If you have one or more of the above medical conditions, work with your physician to help reach your treatment goals. Your treatment may include a combination of medications and healthy lifestyle choices.
Putting It All Together
A stroke is a life-threatening medical condition that can cause significant disability. If you and your loved ones are aware of the warning signs and symptoms of a stroke, it can help you act fast to reduce the risk of serious complications. Making healthy lifestyle choices and managing your long-term medical conditions can help prevent stroke. Work with your physician to find out how you can reduce your stroke risk.
